PubMed Health⌕ Search

Biomedical subjects

Catherine S Todd

Publications and source records attributed to Catherine S Todd.

10 recordsLinked to original sources
PubMed2007

Prevalence and correlates of condom use and HIV testing among female sex workers in Tashkent, Uzbekistan: implications for HIV transmission.

Little is known about sex work in Tashkent, Uzbekistan, despite rapid increases in HIV infection. Consistent client condom use and prior HIV testing are described among 448 female sex workers (FSW) completing a self-administered questionnaire, health provider interview, and HIV testing between April 2003 and March 2004. Participants were recruited through outreach workers using modified snowball sampling. Consistent client condom use was more likely for FSW who were married, knew condoms prevent HIV, and from countries in south Central Asia. Prior HIV testing was less likely for FSW younger than 21 years, who shared drugs with clients, initiated sex work at 18 years or less and had engaged in sex work less than 2 years. Low rates of condom use, particularly by those with risky drug behaviors, indicate that targeted risk-reduction interventions are urgently needed.

AIDS Serodiagnosis↗
PubMed2006

Utilization of contraception and abortion and its relationship to HIV infection among female sex workers in Tashkent, Uzbekistan.

OBJECTIVE: This study aimed to describe reported contraceptive and abortion utilization and their relationship to human immunodeficiency virus (HIV) infection among female sex workers (FSW) in Tashkent, Uzbekistan. METHODS: For this cross-sectional study, women were recruited through outreach workers affiliated with Istiqbolli Avlod. Participants completed a self-administered questionnaire and underwent HIV testing. RESULTS: Of 448 participants, the majority (86.2%, n=386) used contraception; 39.6% reported inconsistent use. Methods most frequently utilized were condoms (50.9%) and intrauterine devices (16.1%). One fourth (24.3%, n=109) reported multiple (>or=3) prior abortions. Inconsistent contraceptive users were more likely to be infected with HIV (AOR=2.72, 95% CI=1.19-6.22), but such infection was not related to a specific contraceptive method, including condoms, or utilization of abortion. CONCLUSIONS: Inconsistent contraceptive use is common and may be a predictor of HIV infection among Tashkent FSW. Factors preventing consistent contraceptive use may be related to HIV risk and require further study in this population.

Abortion, Induced↗
PubMed2006

High HIV prevalence and risk factors among injection drug users in Tashkent, Uzbekistan, 2003-2004.

OBJECTIVES: To determine HIV prevalence and potential associations with sociodemographic and behavioral factors among injection drug users (IDUs) in Tashkent, Uzbekistan. METHODS: Subjects in this cross-sectional study provided sociodemographic and risk behavior data and were tested for HIV antibody with a saliva-based enzyme-linked immunosorbent assay (ELISA), followed by saliva-based Western blot confirmation. RESULTS: Among the 701 IDU subjects enrolled, 209 (29.8%) were diagnosed with HIV infection, HIV infection was more likely among those unemployed (adjusted odds ratio [AOR]=1.47); whose first drug of abuse was heroin (AOR=2.21) or opium poppy extract (AOR=1.61); with a prior history of hepatitis (AOR=1.39); and those who reported never using condoms (AOR=1.65). Independent risk factors associated with HIV infection were heroin as the first illicit drug of abuse, prior hepatitis, lack of condom use, and unemployment. CONCLUSIONS: Heroin use, sexual transmission, and high unemployment seem to play important roles in HIV transmission. Implementation of effective harm reduction strategies is critical to control the expansion of the HIV epidemic in this country as well as in this region.

Adolescent↗
PubMed2006

Prevalence and correlates of human immunodeficiency virus infection among female sex workers in Tashkent, Uzbekistan.

OBJECTIVES/GOAL: To assess prevalence of and correlates to human immunodeficiency virus (HIV) infection among female sex workers in Tashkent, Uzbekistan. STUDY DESIGN: Women participating in this cross-sectional study completed a questionnaire and HIV testing between April 2003 and March 2004. Logistic regression analyses determined correlation of variables to HIV infection. RESULTS: Of 448 women, 10% (45) were HIV infected, which was associated with ever injecting drugs (AOR = 20.20; 95% confidence interval [CI], 7.69-53.07), street-based sex work (AOR = 4.52; 95% CI, 1.84-11.12), exchanging sex for drugs (AOR = 4.74; 95% CI, 1.84-12.18), and more sexually transmitted infection treatments in the preceding 3 months (AOR = 2.43; 95% CI, 1.14-5.17). CONCLUSIONS: Although injection drug use is the strongest correlate to HIV infection, sexual risk behaviors are independently related and should receive focus in prevention efforts targeted to this population.

Adolescent↗
PubMed2005

Drug use and harm reduction in Afghanistan.

Opium has been cultivated in Afghanistan since 1100 A.D., although production has steadily increased since 1979. Currently, Afghanistan produces three-quarters of the global opium supply, with injection drug use and HIV currently following the opium trade route through Central Asia. Although systematic studies are lacking, heroin use appears to be on the rise in Afghanistan. The purpose of this paper is to briefly provide historical background and current statistics for drug production and use in Afghanistan, to discuss the new government's policies towards problem drug use and available rehabilitation programs, and to assess Afghan harm reduction needs with consideration of regional trends.

Journal Article↗
PubMed2005

Unintended pregnancy risk in an emergency department population.

OBJECTIVE: To assess unintended pregnancy risk and associated factors among female urban Baltimore emergency department (ED) attendees. METHODS: A cross-sectional anonymous questionnaire study was completed by 790 women, sufficient to detect a 5% difference of unintended pregnancy risk in the national population and a 10% intersite difference with 80% power. The results were analyzed with chi-square tests, univariate and multivariate logistic regression analyses. RESULTS: Female ED attendees are at greater risk for unintended pregnancy (33.5%), particularly those of lower income (p=.006) and without a primary care provider (p=.003). Unintended pregnancy risk did not vary between sites by any variable except young age despite the fact that sites varied significantly by race, insurance and income measures. CONCLUSION: Women using the ED are at increased risk for unintended pregnancy and are less likely to have access to a regular medical care source; thus, the ED represents a possible contraceptive provision site.

Adolescent↗
PubMed2005

Primary care services for an emergency department population: a novel location for contraception.

OBJECTIVE: To assess contraceptive provision site preferences in female urban Baltimore emergency department patients. METHODS: This cross-sectional questionnaire study was completed by 790 women, a population sufficient to detect a 10% intersite difference. The results were analyzed with chi-square, univariate and multivariate logistic regression analyses. RESULTS: Obtaining contraception other than from a physician's office was acceptable to 57.2% of the subjects, particularly those uninsured (p=.006) and without primary care providers (p<.001). Contraceptive provision in the emergency department (ED) was acceptable to 44.0%, particularly those who are frequent ED users (p=.003) and those at risk for unintended pregnancy (p=.024; pooled, p<.001). Care in nontraditional settings may preclude pelvic examination; 34.0% of the subjects felt safe obtaining contraception without this examination, significantly for those desiring contraceptive provision in the ED. CONCLUSION: Contraceptive services are acceptable in nontraditional settings, including the ED, particularly to women of limited resources. This service is acceptable without pelvic examination for a sizable proportion of the women using the ED.

Adolescent↗
PubMed2002

Buccal misoprostol as cervical preparation for second trimester pregnancy termination.

The objective of the study was to assess the efficacy of cervical preparation with misoprostol or laminaria suction abortion up to 18 weeks gestation. The study was conducted among a consecutive case series of patients presenting for dilatation and evacuation at a single center. Cervical preparation was effected by either 600 mg buccal misoprostol (n = 32) or laminaria (n = 78). Dilatation and evacuation was then performed using vacuum aspiration, with fetal parts or placenta removed as necessary with appropriate forceps. The principle outcome of interest was procedure time. Complete abortion was effected in 100% of the cases. In all cases, the cervix was adequately prepared to allow either the introduction of a size 14-mm suction cannula or was easily dilated to this diameter. Group size was sufficient for detection of a 20% difference in mean procedure time with 80% power (calculated with two separate standard deviations for procedure time). Procedure times were not significantly different when misoprostol was used compared to laminaria for cervical preparation. It is concluded that the use of misoprostol to provide cervical preparation in second trimester abortion procedures appeared effective and offers an alternative to laminaria. Buccal misoprostol should be more widely investigated for this purpose.

Abortifacient Agents, Nonsteroidal↗
PubMed2002

Ectopic pregnancy after cesarean hysterectomy.

BACKGROUND: Ectopic pregnancy after a total abdominal hysterectomy is rare and, for this reason, delay in diagnosis may occur when such a patient presents with abdominal pain. CASE: A multiparous patient with a history of cesarean hysterectomy 12 years before presented to the emergency department with abdominal pain and incidental positive urine beta-human chorionic gonadotrophin (hCG). A computed tomography scan revealed a loculated left cystic mass in the pelvis. Laparotomy findings revealed a left adnexal mass; pathology revealed chorionic villi consistent with pregnancy. CONCLUSION: Ectopic pregnancy may occur after hysterectomy, but typically presents near the time of surgery and is more commonly associated with vaginal hysterectomy. However, because ectopic pregnancy is possible after hysterectomy, it should be considered in the differential diagnosis of adnexal mass in such a patient.

Adnexal Diseases↗